Review by bluej33

"Experience Surgery in a Whole New Way"

I would assume that a good number of people out there have undergone surgery -- I myself have multiple times. And from my end, it's all pretty easy. Sure, there's a bit of anxiety going into it (“What if they give me too much anesthesia?”), but in 30 minutes I'm up and feeling fine. But have you ever thought about what it's like on the doctor's end? What do you do with someone who's on the line, who's put their life into your hands? Do you have what it takes? Well, you're about to find out…

I'll begin very much to the point: Trauma Center is hands definitely one of my favorite games for the DS. I, like many other DS owners out there, was somewhat disappointed with the lack of really innovative games for the system. With this incredible touch screen, why weren't there more games that really took advantage of it? Where were all the games that could only be done on the DS?

Well, Trauma Center was definitely one of them (not any more, though -- the series now has games on the Wii). It may seem unorthodox to have a game revolving around playing doctor on the DS, but it actually works quite well. The controls, specifically, work very well; the touch screen serves as an excellent channel to emulate actions executed by all sorts of medical tools.

The game is divided up into chapters, which are in turn divided into operations. There are six chapters, with around 10 operations each. Each operation has some specific goal; at the beginning, they are fairly mundane. Beginning operations include such standard OR procedures as patching up somebody who ran crashed on a motorcycle.

As you progress further and further into the game, though, the mission variety becomes quite impressive. Operations will shift from the ordinary to the extraordinary, requiring you to solve puzzles and find the weaknesses of many viruses in an attempt to save your patients. While the operations are by no stretch of the imagination realistic, they are quite varied; there are some repeated levels, but the second time you play through a virus, it is a souped-up version of the original.

But how exactly do you perform operations? It's quite simple, really: with the help of your trusty DS stylus and ten in-game tools. The tools you'll put to work are actually quite standard, including antibiotic gel, a scalpel, forceps, a laser, thread and needle, or even your (gloved) hand.

Every operation (with only a few exceptions) begin with you opening up the problem spot on your patient. Inside, there's usually some sort of problem; perhaps there is glass under your patients skin, or maybe there's an evil worm-like virus attempting to eat out your patient's heart. Whatever the problem, your ten tools will be put to work as you attempt to cure the patient's ailment and put their infections to rest.

Around all this operating is a surprisingly well-written story. You take on the role of rookie doctor Derek Stiles. After being placed in a high-pressure situation, he is found to have a mysterious ability inherited from Aeschylus, the world's first doctor: the Healing Touch. He must use this ability and the help of fellow doctors and nurse Angie Blackwell to combat an evil infection of viruses called G.U.I.L.T. Behind these world-threatening viruses is the enigmatic medical bioterrorism organization Delphi. For such a gameplay-oriented title, Under the Knife does a surprisingly good job of incorporating the plot smoothly in with the rest of the game, and some shockingly well-done plot twists.

The character development is also very well-done. In between operations, you'll get short conversations between multiple characters. In addition to progressing the ever-twisting and highly entertaining plot, these conversations do an incredible job of developing the characters and making them seem completely lifelike. Some characters are far deeper than they first appear, and while development for some secondary characters is a little lacking, the way that the five or so truly “main” characters are handled is phenomenal. In fact, if you're a fan of such TV shows as House, M.D. or Grey's Anatomy, then you'll feel right at home with the way characters in Trauma Center are developed.

Additionally, the above-mentioned Healing Touch plays a big role in gameplay as the plot progresses and the game's operations get a lot tougher. Chose your hand as a tool and quickly draw a large star across the touch screen. Time will immediately slow down and damage taken by your patient will drop dramatically. In addition to making Derek seem ridiculously cool, the Healing Touch is critical for operations when you just need a little bit of extra help to squeak by.

Under the Knife also earns some points because it's avoided the DS stigma, if you will, that games for the DS are easy. Because, as those who have played it no doubt now, Under the Knife is devilishly tough. For one, there's a restrictive time limit placed on each level. For beginning levels, this doesn't present much of a problem; however, as you progress through the game, that time limit is going to become your worst enemy. You'll have to act quickly and decisively in order to come out with a “Mission Completed”.

To add further to the already ramped-up difficulty is the fact that your patients' vital signs drop very quickly; certain “attacks” by malicious viruses can knock down your patients' vitals by up to 30 or even 50 points -- which is more worrisome when you consider that the maximum number for vital points is never more than 99. You've got to constantly be on the attack when trying to save a patient, but at the same time you've got to balance that with injecting your patients with healing serum and ensuring that they don't die as you treat them.

It's definitely worthy of note, then, that Trauma Center is not really for the casual gamer. If you're just looking for a way to pass the minutes at the bus stop or in the doctor's office, there's probably a better title out there for you. Trauma Center is addicting enough that it's tough to put down (even when you keep losing multiple times in a row), and it's hard enough that it can easily frustrate anyone who's not in to gaming. That said, if you're on the fence about this title because of its difficulty level, know that it's overall an extremely rewarding game, and the fantastically-written story line and loveable characters may provide enough incentive for you to keep banging your head against the same wall -- it did for me, anyway.

Graphically, Trauma Center is fine. It's similar to Fire Emblem games in regards to the way that story scenes unfold. Sadly, there are no custcenes, but plot sequences take place with a picture of a character next to whatever it is that he or she is saying. The operation graphics are also decent, but nothing spectacular. Things look nice, organs are (surprisingly) easily identifiable, and the blood, while realistic, isn't graphicly so. While it's by no means the best looking DS game out there, the visuals easily serve their purpose.

The music is in similar boat, although overall it is better than the visual quality of Under the Knife. The music is well-done, though slightly forgettable. Still, as far as immersion goes (a big aspect of any game in my book), the music is well done and definitely contributes a lot. There's also some occasional voice work, though it's not used for story points. Rather, during some operations, a vocal cue (your nurse shouting, “Come on, Doctor!”, for example) is the only hint given to you that you need to take drastic action now. That said, you'll probably need the sound the entire game, because you never know when such a moment will be sprung upon you. Still, that's not a bad thing, because it'll expose you to the game's music and make Under the Knife an overall more enjoyable game.

There's also a good amount of replay value, thanks to the fact that you can easily go back and play any level that you want, so long as you've beaten it in the story mode. You're given a letter rank, ranging from D, worst, to S, best, for each level that you complete. For completionists out there who want to get an S on every single operation (no mean feat, considering how tough the operations are normally), there's a lot of work to be done, and you are ensured many, many hours of game time with this title, even once the credits have rolled.

Overall, Trauma Center: Under the Knife is one of the best, most innovative, and most addicting titles out there for the Nintendo DS. While it may not be the best choice for casual gamers thanks to its high difficulty level, it is incredibly rewarding for those willing to stick with it and play the game to its satisfying finale. Gameplay is intense, fun, and addicting, the story is wonderful and supported by some great-written characters, and there's plenty of game value. If you're looking for a challenging, exciting gaming experience for the DS, you owe it to yourself to start poking around for a copy of Trauma Center: Under the Knife.

Reviewer's Rating:   4.5 - Outstanding

Originally Posted: 11/09/07, Updated 11/12/07

Game Release: Trauma Center: Under the Knife (US, 10/04/05)

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